Organization
MEDICOS SELECTOS DEL NORTE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MILDALIAS DOMINGUEZ PASCUAL MD (PRESIDENT)
(787) 883-0124
Entity
Organization
Contact information
Practice address
CARR #2 KM 31 9 BARRIO BAJURA, VEGA ALTA, PR 00692
(787) 883-0124
(787) 883-7645
Mailing address
P.O. BOX 4317, PUERTO RICO, PR 00694-4317
(787) 883-0124
(787) 883-7645
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
04/20/2007
Last updated
08/22/2020
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